The Acceptability and Impact of the Xploro Digital Therapeutic Platform to Inform and Prepare Children for Planned Procedures in a Hospital: Before and After Evaluation Study

Background There is increasing interest in finding novel approaches to improve children’s preparation for hospital procedures such as surgery, X-rays and blood tests. Well prepared and informed children have better outcomes (less procedural anxiety, higher satisfaction). A digital therapeutic (DTx) platform (Xploro®) was developed with children to provide health information through gamification, serious games, a chatbot and an augmented reality avatar.Objective The purpose of this before and after evaluation study was to assess the acceptability of the Xploro® DTx and examine its impact on children and their parents’ procedural knowledge, procedural anxiety and reported experiences when attending hospital for a planned procedure.Methods We used a mixed-method design with quantitative measures and qualitative data collected sequentially from a group of children who received standard hospital information (before group) and a group of children who received the DTx intervention (after group). Participants were children aged between 8-14 years and their parents, who attended hospital for a planned clinical procedure at a children’s hospital in the North West of England. Children and their parents completed self-report measures (perceived knowledge, procedural anxiety, procedural satisfaction, procedural involvement) at baseline, pre-procedure and post-procedure. Results80 children (n=40 standard care group, n=40 intervention group) and their parents participated, children were aged between 8-14 years (average 10.5 years) and were attending hospital for a range of procedures. The children in the intervention group reported significantly lower levels of procedural anxiety before the procedure compared to children in the standard group (t = 7.506, P = .008). The children in the intervention group also felt more involved in their procedure compared to children in the standard group (t = -2.238, P = .03. The children in the intervention group also reported having significantly higher levels of perceived procedural knowledge (t = -4.457, P < .001) than those in the standard group. As for parents, those with access to the Xploro intervention reported significantly lower levels of procedural anxiety pre-procedure compared to those who did not (t = 3.942, P = .051).During the semi-structured ‘write and tell’ interviews, children stated that they enjoyed using the intervention, it was fun and easy to use and they felt that it had positively influenced their experiences of coming to hospital for a procedure.ConclusionsThis study has shown that the DTx platform (Xploro) has a positive impact on children attending hospital for a procedure, by reducing levels of procedural anxiety. The children and parents in the intervention group described Xploro as improving their experiences and being easy and fun to use.